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Monday, March 6, 2023

Obesity is more complex than just overeating , Not just fat

 In conjunction with World Obesity Day yesterday, we take a look at how the understanding of this condition of excess weight has evolved.

We need to avoid weight bias where we make the assumption that people are obese solely because of their own choices. — Photos: 123rf.com

For as long as she could remember, Jane had always been plus-sized.

As a child, her family doted upon her as she was never picky about food and would eat anything given to her.

In school, she was always physically bigger compared to the rest of her peers.

She was often teased by her friends for her body size, but she was constantly reassured by her family that she was just “big-boned”, just like the rest of her siblings and family members.

However, by the time she reached young adulthood, she started feeling more self-conscious about her body size and embarked upon multiple cycles of crash dieting and exercise regimes.

She successfully lost weight a few times; however, each time she lost weight, she would eventually lapse into bouts of uncontrollable binge-eating.

As a result, she constantly struggled to keep the weight off and would always gain back the weight she lost, if not more.

With time, she became resigned to the fact that she was probably fated to be fat for life.

This led to body image issues, self-blaming, and even clinical depression that negatively affected her life and relationships.

The scale of the problem

Jane is not exactly a real person, but her story is very real – a coalescence of the lives of many people struggling with weight issues everywhere.

The global obesity epidemic, aptly coined “globesity”, is arguably one of the most important public health concerns of the late 20th and early 21st century.

As of 2016, the World Health Organization (WHO) estimated that 650 million adults worldwide were obese.

According to the World Obesity Atlas, these numbers are expected to increase, with the global obese population projected to breach the one billion mark by 2030.

It is also no longer news to us that Malaysia is effectively the fattest country in the region.

The 2019 National Health and Morbidity Survey (NHMS) reported that one in two Malaysian adults were either overweight (30.4%) or obese (19.7%), and one in three Malaysian children were overweight (15.0%) and obese (14.8%).

On top of this, if we account for the rampant weight gain seen during the Covid-19 movement control order, the current true numbers of obese people in Malaysia is likely even higher.

Traditionally, being overweight and obese has been viewed as a risk factor that increases an individual’s chances of developing metabolic diseases such as type 2 diabetes, hypertension (high blood pressure), cardiovascular (heart) disease, obstructive sleep apnoea, and musculoskeletal disorders such as osteoarthritis, among others.

This fact still very much holds true today.

However, in 2014, the American Medical Association declared obesity as a disease state in itself.

This actually had very far-reaching implications.

It effectively changed the way we view obesity – as more than just excessive fat deposition contributing to other diseases.

Obesity itself is now seen as a disease state that requires formal medical attention, proper treatment plans and prevention efforts.

The complexity of obesity

Experts worldwide have been calling for measures to be taken to curb this growing issue for decades, but the rates of obesity have continued to rise regardless.

The idea that obesity is a disease of the brain is gaining traction among scientists as the hypothalamus (in yellow) plays a key role in regulating our appetite and metabolism..The idea that obesity is a disease of the brain is gaining traction among scientists as the hypothalamus (in yellow) plays a key role in regulating our appetite and metabolism.>>

This is because obesity is a very complex issue with a lot of interconnected causes.

In the past, it was assumed that as our society became richer, we had to physically work less to get our food and this led to over-nourishment.

However, we now know that it is overly simplistic to think that obesity develops as a result of an individual just “eating too much”.

Instead, there are often multiple factors beyond our control that contribute to an individual developing obesity.

For example, people who come from disadvantaged socioeconomic backgrounds may not have the financial privilege of accessing healthy food options.

They may also not be educated enough to choose better quality food with their available resources.

Children born into these families with a history of obesity have higher chances of developing obesity later on in life.

This is partly contributed by genetic factors, as well as enduring lifestyle habits inculcated from a young age that may be difficult to change.

Obesity is also closely linked to the development of mood disorders such as depression and anxiety.

People suffering from depression also have a higher chance of developing eating disorders that subsequently lead to obesity.

A lot of these factors form vicious cycles that span generations.

On a population scale, we are living in an increasingly “obesogenic environment”.

This refers to the multiple physical, economic and sociocultural factors that collectively contribute to the development of an obese population.

For example, our built environment promotes a sedentary lifestyle.

Our roads are hardly pedestrian or bicycle-friendly.

Our public transportation system is not optimised, as the lack of last-mile connectivity remains a major hindrance for many.

As a result, most Malaysians are heavily dependent on motorised vehicles to get around, rather than walking or cycling.

Globalisation and industrialisation of the food supply chain have made ultra-processed foods more common now than ever.

Ultra-processed foods refer to those that have gone through a series of industrial processes, often with ingredients like high-fructose corn syrup, modified oils, food colouring and other additives to make the final product hyper-palatable.

These foods are commonly high in calories and easily over-consumed.

They are generally mass-produced and marketed by large companies, and are often much cheaper and more readily available compared to whole, nutritious food options.

As we start to understand more about obesity, it has become increasingly clear that it is, in essence, a disease of the brain.

The hypothalamus located in the brain plays a key role in regulating our appetite and metabolism.

The satiety centre in the hypothalamus is largely responsible for controlling our sensation of hunger.

When an individual develops obesity, the accumulation of excessive fat tissue actually leads to a host of hormonal changes within the body.

These hormonal changes not only suppress the satiety centre and increase hunger, but also slow down our metabolism rate.

Essentially, our body has a weight “setpoint”, and will try to revert to this setpoint despite our best efforts.

These underlying biological mechanisms are largely out of our voluntary control.

They also explain why people with obesity who embark on lifestyle changes to lose weight tend to hit a plateau after an initial weight loss.

In fact, after some time, they may regain some of the weight they lost initially.

Weight bias

The easy availability and affordability of ultra-processed foods is part of the obesogenic environment that makes it easy to gain excess weight. — TNS 
The easy availability and affordability of ultra-processed foods is part of the obesogenic environment that makes it easy to gain excess weight. — TNS

It is precisely because of these underlying complexities that we should be careful not to indulge in weight bias.

Weight bias, or weight stigma, refers to negative attitudes, beliefs and judgments toward individuals who are overweight and obese.

In other words, we have to avoid the over-simplistic assumption that people with obesity are the way they are as a result of their “poor life choices”.

This stigma is very common because body weight is a physical characteristic that is visible and is often the first thing we notice about a person.

Studies have shown that even doctors are guilty of weight bias.

These can range from explicit behaviours, such as outright fat-shaming and teasing, to implicit beliefs, such as seeing someone who carries excessive weight and immediately considering them to be lazy, undisciplined or unmotivated.

Shaming individuals with weight-related issues does not motivate positive behavioural changes.

Instead, it often leads to the development of unhealthy behaviours such as compulsive exercise, as well as eating disorders such as cycling between extreme fasting or dieting, and episodes of binge eating.

Worse still, when this becomes internalised, an individual believes that they deserve the stigma and discriminatory treatment because of their weight.

Internalised weight bias is strongly associated with unhealthy eating patterns, poor body image, low self-esteem and depression.

Striking a balance

Conversely, this by no means indicates that we should normalise obesity or dismiss the deleterious health effects associated with it.

Instead, an individual’s body fat excess needs to be objectively taken into context as one part of their overall health.

The body positivity movement promotes acceptance of all body types, shapes and sizes, and not assigning self-worth solely to outward appearances.

This need not be mutually exclusive with taking obesity seriously as a public health emergency requiring urgent attention.

Over the last few decades, there have been major advances in the medical treatment of obesity.

Bariatric surgery has long been proven to be very effective, but it comes with its own set of complications.

New medications have been developed to specifically target the hormonal changes in obesity and induce very effective weight loss.

However, these medications are still very expensive and may not be widely available.

It also does not take away the fact that prevention is still better than cure.

Once established, obesity is very difficult and arduous to treat due to the reasons explained above.

Preventing obesity requires a concerted effort.

Government policies need to be drafted holistically, keeping in mind that economic and structural development often have indirect population-wide health consequences in the long run.

The food industry needs to be regulated for responsible manufacturing and marketing practices.

Society as a whole also has a collective responsibility to recognize that obesity is a disease and consciously adopt a healthy culture to address and prevent it.

The theme for World Obesity Day 2023 is “Changing Perspectives: Let’s Talk about Obesity”.

It is apt that we keep the conversation going, correct misconceptions, end stigma, and collectively shift towards a rational and sustainable strategy to tackle this perennial issue.

Dr Lim Quan Hziung is a lecturer and internal medicine physician training to become an endocrinologist at University Malaya. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. 

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Sunday, March 5, 2023

A good payday for EPF contributors, as EPF declares 5.35% dividends for 2022

 Dividend a surprise, much more than economists predicted, says ecperts

PETALING JAYA: With the current economic challenges, the 5.35% dividend by the Employees Provident Fund (EPF) for 2022 is considered good for contributors, say economists.

Sunway University Economic Studies Programme director Prof Yeah Kim Leng called it laudable given last year’s challenging local and international financial as well as capital market conditions.

The Russian-Ukraine conflict and spikes in inflation and interest rates weren’t of help either, he said.

ALSO READ: RM145.5bil in EPF withdrawals made since 2020 

“Though lower than last year’s 6.1%, the 5.35% is above earlier expectations that were close to 5%,” said Prof Yeah.

“The performance is also respectable as the fund had to adjust its portfolio to meet the large withdrawals allowed as part of the Covid-19 pandemic support packages,” he said in response to EPF’s announcement yesterday.

The EPF declared a dividend rate of 5.35% for conventional savings, with a total RM45.44bil payout, as well as 4.75% for syariah savings. This amounts to RM5.7bil in payout.

ALSO READ: When wages go up, so will EPF’s funds, says CEO

In total, EPF will be paying RM51.14bil to contributors.

As for unhappiness among contributors over the dividend rates, Prof Yeah said it is not surprising for them to compare EPF returns with other pension funds as such funds are typically more conservative and earn lower but have more stable returns.

“By contrast, funds that generate higher returns entail taking higher risks. Therefore, many growth funds are earning much lower returns because of the financial market downturn in 2022 as evident by the nearly 20% decline in the Global MSCI (Morgan Stanley Capital International) benchmark,” he pointed out.

ALSO READ: Low wages must be addressed, 81% of active EPF members earn RM5,000 or less

Economist Datuk Jalilah Baba said EPF’s dividend rate still exceeded many pundits’ expectations.

“People will still receive payouts, which is a good sign. Perhaps it may not be what was expected but even I expected it to be around 4.5% to 5%.

“Based on EPF’s calculations, they can still afford to give people money, so it is good news for contributors. On the average, this is considered stable.

“If people were to compare, say with 2017 with its 6.9% dividend rate, you also have to look at the economy at the time because now the situation is totally different and filled with uncertainties.

ALSO READ: COMPETITIVE RETURNS AMID TOUGH INVESTMENT CLIMATE

“As such, the scenario has to adjust to the collection they have,” she said.

Meanwhile, corporate executive P. Suganya, 37, from Subang Jaya, Selangor said if EPF continued to give lower rates than previously, Malaysians might have to set aside their savings for other investment schemes as they might not have enough EPF savings for their retirement due to the volatile market.

However, she said most Malaysians could not afford to set aside part of their income for investments due to the high cost of living as well as the anticipated recession.

“This is worrying and the EPF is a fixed and reliable investment most Malaysians rely on. And the contributions are automatic and accounted for,” she said.

ALSO READ: EPF's assets under management drop for first time since 1985

“EPF has to be cautious in its investments in the current volatile market since the fund cited this as a reason for the lower gross investment returns,” she added.

Facebook user T. Gopal Thirumalai commented that even though people were worried about the shrinking size of the funds in EPF, it was important to know that good fund managers would get rid of low-yielding investments, shares and assets that actually give better returns.

“When high returning funds are no longer available and your fund size keeps increasing every month, what would you do with excess funds, month after month?

“On top of that, unlike instruments with fixed dividends, when you invest in shares, you cannot predict future returns.

“A share with historical high returns can become the opposite during uncertain times.

“At that time, you decide on what to do,” he posted on the social media platform. 

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Saturday, March 4, 2023

IC designer Oppstar focuses on talent

 

Oppstar is one the few Malaysian companies in the front-end of the semiconductor industry, offering a full spectrum of IC design services. The chips we design play a prominent role ushering in a new era of digitalization and are used in various industries including telecommunication, consumer electronics, industrial electronics and automotive. 

Oppstar was founded in 2014 by three IC design industry experts, with the vision to become a preeminent global Semiconductor brand in R&D.

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“We would like to grow by double digits for our top and bottom line. our talent is our asset and our retention strategy is to pay them a competitive market rate.” Ng Meng Thai

WHILE Malaysia is known as having a strong base in the semiconductor industry, there are not many companies that operate in the higher parts of the sector’s value chain.

That is beginning to change, as a small number of companies are making a successful business out of designing integrated circuits (ICS).

IC designers, as they are called, design chips which are then tested out and manufactured by other parties.

One such IC designer in Malaysia is Oppstar Bhd, which is slated to be listed on the ACE Market in the middle of this month.

Its upcoming listing will see it raising funds mainly for the purpose of hiring more professional engineers.

This is a departure from the norm in the country’s public listing companies’ inclination where most of the funds raised would usually be channeled towards capital expenditure initiatives such as to build factory capacity or to acquire a fixed asset.

IC designers don’t need such assets as their value is in chip designing, which in turn is done by their engineering talent.

Investing in talent would help Oppstar expand its capacity to take on more projects and boost its competitive edge.

The company says it also aims to develop intellectual property (IP) assets with these new hires. The IP is meant to lead to additional income and at the same time improve its market profile.

In its prospectus, Oppstar says some of the IPS it aims to develop are for the RISC-V (or risk-five) based system on a chip. Such a system enables artificial intelligence and machine-learning applications to run on chips.

“These are technical terms in the industry but we can license these IPS separately or incorporate the IPS into future IC design projects,” Oppstar’s chief executive officer Ng Meng Thai tells Starbizweek.

The company would also like to expand into “post-silicon validation services” which would complement its IC design business.

The move would help improve its standing among its peers, says Ng, adding that all these plans would enable it to continue on its strong growth trajectory.

“We would like to grow by double digits for our top and bottom line. Our talent is our asset and our retention strategy is to pay them a competitive market rate,” Ng says.

Oppstar aims to more than double its engineering headcount to 500 from 220 presently and this effort would take up close to half of the funds or Rm50mil raised from its initial public offering (IPO).

Ng claims that demand for the company’s expertise is strong as it wants to expand its geographic reach to India, Singapore and Taiwan with the allocation of about a quarter or Rm25mil of the IPO proceeds.

“From time to time, we receive enquiries from customers. For the next three years or so, we would still need to continue to go out to find more customers to consume our capacity of 500 staff,” he says.

Its customers comprise integrated device manufacturers, fabless and fablite companies, electronic system providers and other IC design houses.

End-industries that require such expertise are the consumer electronics, telecommunications, industrial electronics and automotive sectors.

Its financials showed a gross profit margin of close to 60% and net profit margin of 33% in the financial year 2022 (FY22).

The company says its strong margins are driven by having turnkey design service projects, which command better margins when compared to specific design services.

As at the time of its prospectus issuance, Oppstar’s order book stood at Rm34.29mil, which mainly consists of turnkey design services and is expected to be recognised in the next 12 months.

With zero borrowings, Ng says the company will be in a good position to quickly capture opportunities and have these delivered to its bottom line immediately.

Notwithstanding that, retaining its talent that grants it its competitive advantage is key to its sustenance.

“We notice that younger talent are a bit different in valuing a job from what was considered as good 10 to 20 years ago, as workers then tend to value jobs from multinational companies (MNCS).

“Younger engineers surprisingly now would like to try all the different IC designs before locking themselves down in their career,” he says.

“If you go to an MNC, you would be focused on a very niche and narrow field in IC design. But since we have a broad customer base, our engineers will have the opportunities to experience a variety of design work.

“Also we have overseas customers as some 80% of our revenues are from overseas, so there are a lot of travelling opportunities for them as well,” Ng adds.

He points out that some 14% of the company’s public issue of new shares would be available for its eligible directors, employees and business associates who have contributed to its success.

“This would help us retain some of our talent for the longer term. Last year, we saw a low single-digit rate in the turnover of our manpower.

“The original team of the three founders that started the company have stayed on until now and we grew the employee count to about 220 currently,” he adds.

The company is also eyeing other growth opportunities such as through joint ventures and inorganic ones after its listing. 

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